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General NPI Number Information
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NPI Number | 1912111204
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Entity Type | Organization
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Legal Business Name | BARBARA WELLER LICSW LLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5170 MCQUADE ROAD
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City | DULUTH
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State | MN
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Zip | 55804-2943
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Country | US
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Telephone | 218-525-2059
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Fax | 218-525-1864
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Provider Business Mailing Address
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Address Line | 5170 MCQUADE ROAD
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City | DULUTH
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State | MN
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Zip | 55804-2943
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Country | US
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Telephone | 218-525-2059
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Fax | 218-525-1864
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA J WELLER
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Credential | LICSW MSW
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Telephone | 218-525-2059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 00300
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 00300
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License Number State | MN
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